[1]杨 超,苗 丽,马建彩,等.早发型重度子痫前期患者血清SPA,SPD 及Hcy 表达及临床意义[J].现代检验医学杂志,2023,38(01):186-190.[doi:10.3969/j.issn.1671-7414.2023.01.035]
　YANG Chao,MIAO Li,MA Jian-cai,et al.Expression and Clinical Significance of Serum SPA, SPD and Hcy in Patients with Early-onset Severe Preeclampsia[J].Journal of Modern Laboratory Medicine,2023,38(01):186-190.[doi:10.3969/j.issn.1671-7414.2023.01.035]
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早发型重度子痫前期患者血清SPA,SPD 及Hcy 表达及临床意义()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年01期
页码:
186-190
栏目:
检验与临床
出版日期:
2023-01-15

文章信息/Info

Title:
Expression and Clinical Significance of Serum SPA, SPD and Hcy in Patients with Early-onset Severe Preeclampsia
文章编号:
1671-7414（2023）01-186-05
作者:
杨 超; 苗 丽; 马建彩; 郑路路; 李瑞雪; 杨丽萍
（邯郸市中心医院妇产科, 河北邯郸 056000）
Author(s):
YANG Chao;  MIAO Li;  MA Jian-cai;  ZHENG Lu-lu;  LI Rui-xue;  YANG Li-ping
（Department of Obstetrics and Gynecology, Handan Central Hospital, Hebei Handan 056000, China）
关键词:
早期重度子痫前期; 表面活性蛋白A; 表面活性蛋白D; 同型半胱氨酸
分类号:
R714.245；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.01.035
文献标志码:
A
摘要:
目的 探讨早发型重度子痫前期（early onset severe pre-eclampsia，EOSP）患者血清表面活性蛋白A（surfactantassociated protein A，SPA）、表面活性蛋白D（surfactant associated protein D，SPD）及同型半胱氨酸（homocysteine，Hcy）表达及临床意义。方法 选取2020 年8 月~2021 年8 月期间邯郸市中心医院诊治的124 例EOSP 患者为研究对象，以同期60 例健康体检孕妇为对照组。酶联免疫吸附实验（ELISA）检测各组血清SPA,SPD 及Hcy 水平。比较两组一般资料及血清SPA, SPD 及Hcy 水平的差异。Pearson 相关分析血清SPA,SPD 及Hcy 水平与临床参数的相关性。多因素Logistic 回归分析影响EOSP 发生的影响因素。受试者工作曲线（ROC）分析血清SPA, SPD 及Hcy 对EOSP 的诊断价值。结果 相比于对照组，EOSP 组血清SPA(13.27±5.14ng/ml vs 22.14±6.04ng/ml)，SPD(8.73±2.38ng/ml vs19.34±3.46ng/ml) 水平明显降低，Hcy(15.27±3.13μmol/L vs 8.35±2.32μmol/L) 水平明显升高，差异具有统计学意义（t=10.353，24.299, 15.214，均P ＜ 0.05）。EOSP 组患者血清SPA,SPD 水平与新生儿出生体质量呈正相关（r=0.515,0.447,均P ＜ 0.05)，与体质量指数、舒张压、收缩压和24h 尿蛋白定量呈负相关(r=-0.604 ~ -0.413, 均P ＜ 0.05)；血清Hcy水平与新生儿出生体质量呈负相关（r=-0.538, P ＜ 0.05)，与体质量指数、舒张压、收缩压和24h 尿蛋白定量呈正相关(r=0.420 ~ 0.610, 均P ＜ 0.05)。24h 尿蛋白定量[1.266（1.110~1.444）]、舒张压[1.270（1.071~1.506）]、SPA[0.865（0.778~0.962）]，SPD[0.877（0.781~0.985）] 及Hcy[1.347（1.084~1.675）] 是影响EOSP 发生的独立因素。血清SPA，SPD 和Hcy 联合检测对EOSP 诊断的曲线下面积（95%CI）为0.909(0.877~0.945)，显著高于SPA，SPD 和Hcy各指标单独检测0.780(0.726~0.836)，0.758(0.705~0.810)，0.740(0.692~0.789)，差异具有统计学意义(Z=4.370，5.567，7.702，均P ＜ 0.05)。结论 子痫前期患者血清SPA 和SPD 降低，Hcy 升高，三者共同参与EOSP 疾病发生发展，是影响ES-PE 发生的独立危险因素。
Abstract:
Objective To investigate the expression and clinical significance of serum surfactant protein A (SPA), surfactant protein D (SPD) and homocysteine (Hcy) in patients with early-onset severe preeclampsia(EOSP). Methods A total of 124 patients with EOSP diagnosed and treated in Handan Central Hospital from August 2020 to August 2021 were selected as the research objects, and 60 healthy pregnant women during the same period were selected as the control group. The serum levels of SPA, SPD and Hcy in each group were detected by enzyme-linked immunosorbent assay（ELISA）. Statistical analysis was performed to compare the general data and serum levels of SPA, SPD and Hcy between the two groups. The correlation between serum SPA, SPD and Hcy levels and clinical indictors were analyzed by Pearson correlation analysis. Factors for the occurrence of EOSP were analyzed by multivariate Logistic regression analysis. Serum SPA, SPD and Hcy in the diagnosis of EOSP were analyzed by receiver operating curve(ROC) analysis. Results Compared with the control group, SPA (13.27 ± 5.14ng/ml vs 22.14 ± 6.04ng/ml), and SPD (8.73 ± 2.38ng/ml vs 19.34 ± 3.46ng/ml) were significantly decreased, while Hcy (15.27±3.13 μmol/vs 8.35 ± 2.32 μmol/L L) was significantly increased, the differences were statistically significant (t=10.353，24.299，15.214，all P<0.05). The serum SPA and SPD levels in the EOSP group were positively correlated with newborn birth weight (r=0.515, 0.447, all P ＜ 0.05), and negatively correlated with body mass index, diastolic blood pressure, systolic blood pressure and 24-hour urine protein quantification (r=–0.604 ~–0.413, all P ＜ 0.05). Serum Hcy level was negatively correlated with newborn birth weight （r=–0.538, P ＜ 0.05), and was positively correlated with body mass index, diastolic blood pressure, systolic blood pressure, and 24h urinary protein quantification(r=0.420 ~ 0.610, all P ＜ 0.05). 24h urine protein quantification [1.266(1.110~1.444)], diastolic blood pressure [1.270(1.071~1.506)], SPA [0.865(0.778~0.962)], SPD [0.877(0.781~0.985)] and Hcy [1.347(1.084~1.675)] would be independent factors affecting the occurrence of EOSP. The area under the curve (95% CI) of combined detection of serum SPA, SPD and Hcy for diagnosis of EOSP was 0.909 (0.877~0.945), which was significantly higher than that of SPA, SPD and Hcy separately detected by 0.780 (0.726~0.836), 0.758 (0.705~0.810) and 0.740 (0.692~0.789) (Z=4.370, 5.567, 7.702, all P<0.05). Conclusion The serum levels of SPA, SPD were decreased, while Hcy increased in patients with preeclampsia increase. They were involved in the occurrence and development of EOSP, and are independent risk factors for the occurrence of EOSP.

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备注/Memo

备注/Memo:
基金项目：河北省医学科学研究课题计划（编号：20220553）。
作者简介：杨超（1985-），女，硕士，主治医师，主要从事子痫前期工作，E-mail:yangchaoyc1985@126.com。
通讯作者：杨丽萍（1980-），女，硕士，主任医师，主要从事子痫前期工作，E-mail:1119673794@qq.com。
更新日期/Last Update: 2023-01-15